MEDICARE: DR. JANET MICHELLE STALLMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A54088	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245276476
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET MICHELLE STALLMAN MD

Provider Business Mailing Address
First Line	:	PO BOX 6100
Second Line	:	PATHOLOGY
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92658-6100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	ONE HOAG DRIVE
Second Line	:
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92658-6100
Country	:	US
Telephone Number	:	949-764-5610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	10/05/2007

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